1 MCQs in Medicine for NEET PG
A 71-year-old former smoker (60 pack-years) presents with severe dyspnea at rest, pursed-lip breathing, barrel chest, and pedal edema. Examination reveals an elevated JVP, left parasternal heave, and a loud P2. Chest CT shows centrilobular emphysema with upper-lobe predominance and flattened hemidiaphragms. Spirometry reveals the pattern marked **A** in the diagram: FEV1/FVC ratio 0.34 (post-bronchodilator), FEV1 28% predicted, RV/TLC 0.62, and DLCO 38% predicted. ABG shows pH 7.36, PCO2 56, PO2 54 mm Hg. Which of the following best explains why the DLCO is reduced to 38% predicted in this patient's spirometric pattern marked **A**?
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